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Uses and Administration Adverse Effects and Precautions Interactions

Uses and Administration Adverse Effects and Precautions Interactions

1518 Cardiovascular

tion of benefit in preventing restenosis, 5 although robust 5. Gomberg-Maitland M, et al. Efficacy and et al. Dose proportionality of sodium evidence is scanty and studies are ongoing. 5·6 treprostinil in . continuous subcutaneous and intravenous infusion. J 6. Fernandez B, Strootman D. The analog, treprostinil sodium, 48: I 9-2 5. 1. Okamoto S, et al. Effects of (triazolopyrimidine), a - provides severe Buerger's disease-a case report and derived growth factor antagonist, in restenosis after 2006; 57: 99-I02. percutaneom transluminal coronary Heart J 1992; treprostinil for treatment of chronic 123: 1439-44. pulmonary arterial hypertension. Ann InternMed 2006; 144: 149-50. 2. Maresta A, et a!. Trapidil (triazolopyrimidine), a platelet-derived growth 8. Channick RN, et al. Safety and efficacy of inhaled treprostinil as add-on ProprietaryPreparations (details are given in Volume B) factor antagonist, reduces restenosis after percutaneous transluminal to in pulmonary arterial hypertension. J Am Coli results of the randomized, double-blind STARC 48: 1433-7. study. 90: 2710-15. 9. Voswinckel R, et at. Favorable effects of inhaled treprostinil in severe Single-ingredient Preparations. Arg.: Remodulin; Austral.: 3. Maresta A, et al. Stare It a multicenter randomized placebo-controlled pulmonary hypertension: results from randomized controlled pilot Remodulin; Austria: Remodulin; Belg. : Remodulin; Canad.: double-blind of trapidil for 1-year clinical events and studies. JAm Coil Cardio/ 2006; 48: 1672-81. Remodulin; Chile: Rernodulin; Cz. : Remodulin; Denm.: Remo­ restcnosis reduction after coronary angioplasty and I 0. Skoro-Sajer N, L dulin; Fin.: Remodulin; Fr. : Remodulin; Ger.: Remodulin; Gr.: 64: 375-82. hypertension. Remodulin; Israel: Remodulin; Tyvaso; Ital. : Remodulin; Neth.: 4. 11. Voswinckel R, Remodulin; Norw.: Remodulin; Port.: Remodulin; Swed. : Remodulin; Switz.: Remodulin; USA: Remodulin; Tyvaso. 12. Hiremath J, et al. TRUST Study Group. Exercise improvement and 5. Khan M, et a!. Intrepide; Trapidil eluting stent. Eurolntervention 2008; 4: plasma biomarker changes with intravenous treprostinil therapy for 405-1 1. pulmonary arterial hypertension: a placebo-controlled trial. J Hea!1 Lung 6. Iaccarino D, et a!. Rationale and study design ofthe OISTER trial: Optical Transplant 2010; 29: 137-49. coherence tomography evaluation of stcnt struts re-endothelialization I 3. McLaughlin VV, et al. Addition of inhaled treprostinil to oral therapy for coronary syndromes-a pulmonary arterial hypertension: a randomized controlled clinical trial. taxus drug- JAm Coll Cardiof 2010; 55: I915-22. eluting stent ll: 536- 43. Administration. A study1 in 23 patients with pulmonary hypertension who were treated with subcutaneous infu­ Preparations sion of treprostinil found that a rapid dose-escalation regi­ Proprietary Preparations (details are given in Volume B) men (weekly or twice-weekly increments of 2.5 nano� grams/kg per minute) lowered infusion-site pain and Single-ingredient Preparations. Braz.: Travisco; Ger. : Rocornal; improved 12-week exercise outcomes without increasing Ital. : Travisco; Jp n: Rocornal. adverse events when compared with a slower dose-escala­ tion regimen (weekly increments of 1.25 to 2 nano­ grams/kg per minute). NOTE. Compounded preparations of triamterene may be Treprostinil !USAN, riNN! l. et al. A clinical comparison of slow- and rapid-escalation in patients with pulmonary hypertension. represented by the following names: 47: 611-18. Co-triamterzide (BAN)�triamterene 2 parts and hydro­ 15AU81; B\lllci:,iAU; • Trepr0stinilo; TrE!Pf<)Stinilt;m; chlorothiazide I part (w/w) Administration in hepatic impairment. Clearance of tre­ Co·triamterzide (PEN)-triamterene and hydrochloro- Tpenpor:n1H>U1. . • . . ({(lR,2R,3a5,9a5)· 2,3,3 a.4;9,9a -Hexahydro-2-hydroxy" l -[(35)-3- prostinil is reduced in patients with hepatic impairment. thiazide. Licensed product information recommends that the initial hyctr()O:.Yottyi)'l.H'benz��lr.den·S'yi.lof)')acetic a.cid. Pharmacopoeias. In Chin., Bur. (sec p. vii), Jpn, and US. C23H,o,,,39Q.5 dose of the infusion should be 0.625 nanograms/kg per minute, and should be increased cautiously, in mild to Ph. Eur. 8: (Triamterene). A yellow, crystalline powder. CAS Very slightly soluble in water and in alcohoL Protect from :... si846cll).7 moderate impairment. No licensed dosage recommenda­ ATC ·� light. BOiAC2 1. tions are given for severe hepatic impairment. However, ATC Vet � QBG IAC!L intravenous treprostinil infusion was reported 1 to be safe USP 36: (Triamterene). A yellow, odourless, crystalline t/Ni! '- RUM6K67E5G. and effective in 3 patients with end -stage disease, powder. Practically insoluble in water, in chloroform, in including I patient who was given 106 nanograms/kg per ether, in benzene, and in dilute alkali hydroxides; very Treprostinil Sodium (r/NNMJ minute for 2 years. slightly soluble in alcohol, in acetic acid, and in dilute Caution is also advocated when titrating upwards from mineral acids; soluble l in 30 of formic acid and l in 85 of 2· the initial dose of inhaled treprostinil in patients with mild to methoxyethanol. Store in airtight containers. Protect from moderate hepatic impairment. light. l. Sakai T, et al. Initial experience using continuous intravenous treprostinil to manage pulmonary arterial hypertension in patients with end-stage liver disease. Transpi lnt 2009; 22: 554--61. Uses and Administration Triamterene is a weak with potassium -sparing Peripheral vascular disease. have been properties which has actions and uses similar to those of used for their vasodilating effect in the treatment of per· amiloride (p. 1299.1). It produces a diuresis in about 2 to 4 ipheral vascular disorders (p. 1272.3), although their role hours, with a duration of 7 to 9 hours. The full therapeutic remains unclear. They may be of benefit in severe Ray­ Uses and Administration effect may be delayed until after several days of treatment. naud's syndrome (see Vasospastic Arterial Disorders, Triamterene adds to the natriuretic but diminishes the Treprostinil, a vasodilator and platelet aggregation inhibitor, p. 1275.3) that is complicated by ulceration, and subcuta· kaliuretic effects of other . It is mainly used, as an is an analogue of the epoprostenol (prosta- � neous treprostinil was used1 successfully to treat severe adjunct to thiazide diuretics such as hydrochlorothiazide cyclin; p. 137 4. 3) and is given in the treatment of 1 refractory digital necrosis in a patient with Raynaud's dis­ pulmonary hypertension (p. 1278.2). Treprostinil sodium is ease and scleroderma. and loop diuretics such as furosemide, to conserve given by continuous subcutaneous infusion; if this route potassium in those at risk from hypokalaemia during the 1. Engel G, Rockson SG. Treprostinil for the treatment of severe digital cannot be tolerated, treprostinil sodium may be given by necrosis in systemic sclerosis. Vase Med 2005; 10: 29-32. treatment of refractory oedema associated with hepatic continuous infusion through a . cirrhosis, heart failure (p. 1262.3), and the nephrotic Doses are calculated in terms of treprostinil: treprostinil syndrome. It is also used with other diuretics in the sodium 1.32 nanograms is equivalent to about 1.25 nan­ Adverse Effects and Precautions treatment of hypertension (p. 1251.1). ograms of treprostinil. The infusion is started with a dose As for Epoprostenol, p. 1375.3; infusion-site reactions are When triamterene is given alone in the treatment of equivalent to treprostinil 1.25 nanograms/kg per minute; if common. Inhaled treprostinil has been associated with signs oedema, the oral dosage range is 150 to 250 mg daily, given this is not tolerated the dose should be halved. The infusion of local irritation including haemoptysis (fatal in one case), in 2 divided doses, after breakfast and lunch. Doses may be 1 rate can be increased according to patient response, by and pneumonia. Treprostinil should be used with caution in given on alternate days for maintenance therapy. More increments of up to 1.25 nanograms/kg per minute each hepatic impairment. than 300 mg daily should not be given. week for the first 4 weeks, followed by increases of up to Smaller doses are used initially when other diuretics are 2.5 nanograms/kg per minute each week. There is limited also given. When used with hydrochlorothiazide, for experience with doses above 40 nanograms/kg per minute. Interactions example, in the treatment of hypertension, an initial dose Treprostinil may also be given by inhalation in an initial Since treprostinil is a vasodilator and inhibitor of platelet of 50 mg of triamterene daily may be used. dose of 18 micrograms inhaled 4 times daily, reduced to 6 or aggregation, care should be taken in patients receiving other Potassium supplements should not be given. 12 micrograms inhaled 4 times daily if the higher dose is not vasodilators or . tolerated. Dosage should then be increased in increments of I 8 micrograms every I to 2 weeks as tolerated, to a Adverse Effects maximum maintenance dose of 54 micrograms inhaled 4 As for Amiloride Hydrochloride, p. 1299.2. Triamterene has times daily. Treprostinil sodium is rapidly and completely absorbed after also been reported to cause photosensitivity reactions, The dose of treprostinil should be reduced in hepatic . It is metabolised by the liver and eliminated with a terminal half-life of about 4 hours. About increases in uric acid concentrations, and blood dyscrasias. impairment, see below. Renal calculi may occur in susceptible patients, and Intravenous treprostinH has been investigated for 80% of a dose is excreted in the urine, rnainly as megaloblastic anaemia has been reported in patients with intermittent claudication. metabolites. The systemic absolute of inhaled treprostinil is about 64% after an IS microgram dose and depleted folic acid stores such as those with hepatic References. about 72% after a 36microgram dose. cirrhosis. Reversible renal failure, due either to acute I. Moller ER, et a!. Trial of a UT -l '5, in patients interstitial nephritis or to an interaction with NSAIDs (see 5: with severe intermittent 231-7. References. under Interactions, p. 1519.2) has occurred. 2. Simouneau G, et at. Continuou<; subcutaneous infusion of treprostinil, a 1. Wade M, et al. Absolute bioavailability and pharmacokinetics of prostacyclin analogue, in patients with pulmonary arterial hyper­ administered by acute subcutaneous infusion. J Clin tension: a double-blind, randomized placebo-controlled trial. Am J Respir 44: 83-8. Crit Care Med 2002; 165: 800-804. 2. Wade M, et a!. Pharmacold.netics of treprostinil sodium Incidence of adverse effects. In a postmarketing surveil­ 3. Vachh�ry J-L, et al. Transitioning from IV epoprostenol to subcutaneous 28-day chronic continuous subcutaneous infusion. J Clin lance study of 70 898 patients1 taking triamterene with treprostinil in pulmonary arterial hypertension. Chest 2002; 121: 1561- 2004; 44: 503�9. hydrochlorothiazide the most common adverse effects 5. were fatigue, dizziness, and nausea. Adverse effects neces­ 4. Oudiz RJ, et al. Treprostinil, a analogue, in pulmonary treprostinil sodium (Remodulin) arterial hypertension with connective tissue disease. Chrst subcutaneous route to normal volunteers. sitated withdrawal in 8.1% of patients. A subgroup analy­ 2004; 126: 42Q-7. 44: 209-14. sis of 21 731 patients2 indicated that hyperkalaemia was

All cross-references refer to entries in Volume A 1519

more common in elderly patients and in those with dia­ Triamterene may interfere with the fluorescent (TpmlM-Ko)t; Triampur Compositum (Tpn:RMrryp KoMrr03HTYM); betes mellitus. measurement of quinidine. It may slightly colour the Triamtel (TprmMTen); S.Afr. : Dyazide; Renezide; Singapore: Spain: Switz. : l. Hollenberg NK, Mickiewicz CW. Postmarketing surveillance in 70,898 urine blue. Apo-Triazide; Salidur; Dyrenium compositumt; patients treated with a triamtercne/hydrochlorothiazide combination Thai.: Dinazide; Dyazide; Turk. : Triamteril; UK: Dyazide; (Maxzide). Am J Cardio/ 1989; 63: 37B-4IB. Dytidet; Frusene; Kalspare; Triamco; Ukr.: Triampur Composi­ 2. Hollenberg NK, Mickiewicz CW. Hyperkalemia in diabetes mellitus: Interactions tum (Tpn:a�myp KoMnmHTYM); USA: Dyazide; Maxzide. effect of a triamterene-hydrochlorothiazide combination. Arch lntem Med J 989; 149: I127-30. As for Amiloride Hydrochloride, p. 1299.3. Pharmacopoeial Preparations . For a report of the effect of triamterene on BP 2014: Co-triamterzide Tablets; Triamterene Capsules; Effects on theblood. There have been case reports of pan­ digoxin concentrations, see p. 1357.2. USP 36: Triamterene and Hydrochlorothiazide Capsules; cytopenia associated with trianlterene therapy.u Some Triamterene and Hydrochlorothiazide Tablets; Triamterene patients had hepatic cirrhosis and the antifolate activity of Dopaminergics. For a report of increased amantadine toxi­ Capsules. triamterene was considered responsible.2 city associated with hydrochlorothiazide and triamterene, l. Castellano G, et al. Pancitopenia aguda see p. 892.2. durante el tratemiento con triamterene de Trichlormethiazide (r!NNJ ® hepcitica: aportaci6n de dos casos. NSAIDs. There have been several reports of renal failure 2. Remacha A, et al. Triamterene-induced mellalc·bla•>tmi" report of two 1983; 5: 127- in patients taking triamterene and NSAIDs.l.2 Both types 34. of drug are nephrotoxic and in combination the effect appears to be additive.3-5 It has been suggested that the suppression of urinary prostaglandins by NSA!Ds could Effects on the kidneys. There have been reports1·4 of renal potentiate the nephrotoxic effects of triamterenc.1 calculi containing triamterene or its metabolites, generally NSAIDs may also antagonise the diuretic action of in patients also taking hydrochlorothiazide. An abnormal triamterene. 6 urinary sediment, which was thought to represent precipi­ tated triamterene, was described. 5 These observations I. Favre L, et al. Reversible acute renal failure from combined triamterene and indomethacin: a study in healthy subjects. Ann InternMcd 1982; 96: were expanded in a crossover study:6 abnormal urinary 317-20. sediment was seen in 14 of 26 patients taking triamterene 2. Hilrk6nen M, Ekblom-Kullberg S. Reversible deterioration of renal but in none taking amiloride. Triamterene and its metab­ function after didufeuac in patient receiving triamterene. BMJ 1986; olites were identified by others in 1 81 of 50 000 renal cal­ 293: 698-9. USP 36: (Trichlormethiazide). A white or practically white, 3. Bailey RR. Adverse renal reactions to non-steroidal anti-inflammatory crystalline powder, odourless or with a slight characteristic culi. 7 Triamterene either formed the nucleus of the stone drugs and potassium-sparing diuretics. Adverse Drug React Bull 1988; odour. Soluble 1 in 1100 of water, I in 48 of alcohol, 1 in or was deposited with calcium or uric acid. One­ (Aug.): 492-5. third of the 18 J stones were entirely or mainly composed 4. Lynn KL, et al. Renal failure with potassium-sparing diuretics. N Z Med J 5000 of chloroform, I in about 4 of dimethylformamide, 1 in of trimnterene and its metabolites and it was suggested I985; 98: 629-33. about 9 of dioxan, and I in 1400 of ether; freely soluble in 5. Sica DA, Gehr TWB. Triamterene and the kidney. Nephron 1989; 51: acetone; soluble in methyl alcohol. that supersaturation of the urine with these substances 454-6 1. could provide suitable nuclei for the crystallisation of cal­ 6. Webster J. Interactions of NSAIDs with diuretics and J3 -blockers: cium oxalate.8 However, other workers were unable to mechanisms and clinical implications. Drugs 1985; 30: 32-41. confirm this and suggested that triamterene and its metab­ ' Profile olites could become incorporated into the protein matrix Pharmacokinetics Trich1ormethiazide is a thiazide diuretic with properties of existing stones. 9 In addition, an epidemiological study1 0 similar to those of hydrochlorothiazide (p. 1404.2). It is Triamterene is variably but fairly rapidly absorbed from the found no evidence that triamterene use was associated given orally for oedema, including that associated with gastrointestinal tract. The bioavailability has been reported with an increased incidence of renal stones. Some heart failure (p. 1262.3), and for hypertension (p. 1251.1). authors11 have therefore considered that there was not to be about 50%. The plasma half-life has been reported to Diuresis begins about 2 hours after an oral dose, and lasts be about 2 hours. It is estimated to be about 60% bound to enough evidence to contra-indicate the drug in patients about 24 hours. plasma proteins. It is extensively metabolised, apparently with a history of recurrent renal calculi. In the treatment of oedema a usual dose has been 1 to via the cytochrome P450 isoenzyme CYPIA2, and is mainly Deposition of triamterene in the urine may also play a 4mg daily or intermittently. In the treatment of hyper­ excreted in the urine in the form of metabolites with some part in the development of interstitial nephritis, which was tension a ·usual dose has been 2 to 4 mg daily, either alone, unchanged triamterene. Triamterene crosses the placenta diagnosed in 4 patients also taking hydrochlorothiazide, or with other antihypertensives. In some patients 1 mg daily and may be distributed into breast milk. over a period of 4 years. 6 has been adequate. Triamterene has also been associated with transient References. decline in renal function and the development of renal I. Pruitt AW, et al. Variations in the fate of triamterene. Clin Phannacol Ther 1977; 21: 610-19. P epa a ions failure.12·13 Several mechanisms may be responsible ...... r ....r t...... 2. Gundcrt-Remy U. et at. Plasma and urinary levels of triamtcrcne and . . including interstitial nephritis, intrarenal obstruction by (details are given in Volume B) cenain metabolites after oral administration to man. Eur .IClin Phamwcot Proprietary Preparations crystalline deposits, and an interaction with NSAIDs (see 1979; 16: 39-44. under Interactions, below) 13 Elderly patients may be 3. Gilfrich HJ, et a!. Pharmacokinetics of triamterene afteriv administration Multi-ingredient Preparations. Fin.: Uretren Comp; Gr.: Tensi­ to man: determination of bioavailability. Eur J Clin Pharmacal I983; 25: plex; Jpn: Irtra. particularly at risk.12 237-41. 1. Ettinger B, et al. Triamterene-induced nephrolithiasis. Ann Intern Med 4. Oral triamterene disposition. Clin Pharmacot Ther 1985; 38: 1979; 91: 745-6. Pharmacopoeial Preparations 2. Socolow EL. Triamterene-induced nephrolithiasis. Ann InternMed I980; 5. Fuhr U, et al. Rate-limiting biotransformation of triamterene is mediated USP 36: Trichlormethiazide Tablets. 92: 437. by CYP1A2. Int J Clin Pharmacol Ther 2005; 43: 327-34. 3. Gault MH, et at. Triamterene urolithiasis. Can Med Assoc J 1981; 124: 1556-7. Hepatic impairment. Triamterene clearance was markedly 4. Grunberg RW, Silberg SJ. Triamterene-induced nephrolithiasis . .lAMA (BAN, r!NN) 1981; 245: 2494-5. decreased in 7 patients with alcoholic cirrhosis and 5. Fairley KF, et a!. Abnormal urinary sediment in patients on triamterene. asdtes.1 The diuretic effect lasted for up to 48 hours in cir­ TriOusaaii; UR,-1501; Tp;r- Lancet 1983; i: 42 1-2. rhotic patients compared with 8 hours in healthy controls. 6. Spence JD, et a!. Effects of triamterene and amiloride on urinary ¢ny<;an. I. Villeneuve JP, et al. Triamterene kinetics and dynamics in cirrhosis. Clin sediment in hypertensive patients taking hydrochlorothiazide. Lancet Pharmacol Ther 1984; 35: 83I-7. 2-A.cetoxy-4-uif!uoromethylbenzcit acid; G-Acetyi-4'(trl• 1985; ii: 73-5. tl u.Qromet.hyl)s�iicyli<:: a(id. 7. Ettinger B, el al. Triamterenc nephrolithiasis . 1980; 244: 2443-5. .JA.i\1A CwHlP,=248.2 8. White DJ, Nancollas GH. Triamterene and renal stone formation . .I Urol Renal impairment. Urinary of triamterene and 1982; 127: 593-7. its metabolite, h ydroxytriamterene sulfate, was signifi­ CAS :__: 322-19-2. 9. et al. Triamterene urolithiasis: solubility, pi<, effect on cantly reduced in patients with renal impairment1 and in crystal formation, and matrix binding of triamterene and its metabolites. ATC -· BO IAC18. .J Lab Clin Med I982; 99: 254-62. the elderly whose renal function was reduced.2 Accumula­ 10. Jick H, et al. Triamterene and renal stones. J Urol (Baltimore) 1982; 127: tion of the active metabolite was possible in patients with 224-5. renal impairment.1 11. Woolfson RG, Mansell MA. Does triamterene cause renal calculi? BMJ In (see p. vii). I. Knauf H, et at. Delayed elimination of triamterene and its active Pharmacopoeias. Bur. 1991; 303: 1217-18. metabolite in chronic renal failure. Eur Clin Pharmacol i983; 24: 453-6. I2. Lynn Kl, et a!. Renal failure with potassium-sparing diuretics. N Z Med J .I Ph. Eur. 8: (Triflusal). A white or almost white crystalline 2. Williams RL, et at. Absorption and disposition of two combination 1985; 98: 629-33. powder. Practically insoluble in water; very soluble in formulations of hydrochlorothiazide and triamtercne: influence of age 13. Sica DA, Gehr TWB. Triamterene and the kidney. Nephron 1989; 51: and renal function. Clin Pharmacal Ther 1986; 40: 226-32. dehydrated alcohol; freely soluble in dichloromethane. 454-61. Store in airtight containers at a temperature not exceeding Preparations 25 degrees. Effects on the skin. Photodermatitis has been reported in a patient taking triamterene.1 Pseudoporphyria, possibly Proprietary Preparations (details are given in Volume B) assodated with exposure to sunlight, occurred in a patient Single-ingredient Preparations. Belg.: Dytac; UK: Dytact; USA: Profile with vitiligo during treatment with triamterene and Dyrenium. Triflusal reduces platelet aggregation by inhibiting cyclo­ hydrochlorothiazide. 2 oxygenase-1 and . It is used in the Multi-ingredient Preparations. Austral. : Hydrene; Austria: Con­ 1. Femcinder. de Corres L, et a!. Photodermatitis from triamterene. Contact fit; Dytide H; Triamteren comp; Triastad HCT; Belg.: Dyta­ management of thromboembolic disorders (p. 1273.2) in Dermatitis 1987; 17: 114-1 5. usual oral doses of 300 to 900 mg daily. 2. Motley RJ. Pseudoporphyria due to Dyazide in a patient with vitiligo. Urese; Dytenzide; Braz. : Diurana; Iguassina; Canad.: Apo-Tria­ BMJ 1990; 300: 1468. zide; Novo-Triamzidet; Nu-Triazidet; Pro-Triazide; Riva-Zide; References. Chile: Drinamil; Hidroronol T; Uren; China: No 0 (OJ;;-); Fin.: l. Murdoch D, Plosker GL. TriflusaJ: a review of its use in cerebral Furesis comp; Uretren Comp; Fr.: Isobar; Prestole; Ger.: Beta­ infarction and , and as thromboprophylaxis in Precautions Turfat; dehydro sanol tri; Diu Venostasin; Diucomb; Diureti­ . Drugs 2006; 66: 671-92. kum Verla; Dociteren; Dytide H; Neotri; Nephral; Propra comp; 2. Gonz3lez-Correa .JA, De La Cwz JP. Trillusal: an anliplmelet drug with a As for Amiloride Hydrochloride, p. 1299.3. Triamterene Tri-Thiazid; Triampur Compositum; Triamteren comp; Triamte­ neuroprotective effect? Cardiovasc Drug Rev 2006; 24: I i-24. should also be given with caution to patients with ren HCTt; Triamteren tri-compt; Triareset; Turfa; Veratidet; 3. G6mez-Isla T, et al. TRIMCI Study Group. A randomized, double-blind, hyperuricaemia or gout, or a history of renal calculi. Gr.: Dyberzide; Hong Kong: Apo-Triazide; Dyazide; India: placebo controlled-trial of triflusal in mild cognitive impairment: the TRIMCI study. Alzheimer Dis Assoc Disord 2008; 22: 21-9. Patients with depleted folic acid stores such as those with Ditide; Frusemene; Irl. : Dyazide; Ital. : Fluss; Mex. : Dyazidet; 4. Anninos H, et al. Triflusal: an old drug in modern antiplatelet therapy. hepatic cirrhosis may be at increased risk of megaloblastic Neth.: Dyta-Urese; Dytenzide; NZ: Triamizidet; Port. : Dyazide; Review of its action, use, safety and effectiveness. Hellenic J Cardio/2009; anaemia. Triam Tiazida R; Rus.: Apo-Triazide (Ano-rpH33H.IJ;); Triam-Co 50: I99-2 07.

The symbol t denotes a preparation no longer actively marketed The symbol (8) denotes a substance whose use may be restricted in certain sports (see p. viii)

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